Therapeutic value No judgement
Total cost 42,120,000.00
Registration phase Registration application pending
ATMP Unknown


Active substance



Oncology and Hematology

Reason of inclusion

Indication extension

Main indication

Other oncology

Extended indication

Extension of indication to include first-line treatment of unresectable or metastatic microsatellite instability-high (MSI H) or mismatch repair deficient (dMMR) colorectal cancer in adults for Keytruda.

Proprietary name




Mechanism of action

PD-1 / PD-L1 inhibitor

Route of administration


Therapeutical formulation

Intravenous drip

Budgetting framework

Intermural (MSZ)

Additional comments
Humanised monoclonal IgG4 antibody against the programmed death-1 (PD-1) protein.


Registration route

Centralised (EMA)

Submission date

July 2020

Expected Registration

March 2021

Orphan drug


Registration phase

Registration application pending

Additional comments
FDA grants Breakthrough Therapy Designation to pembrolizumab for treatment of patients with microsatellite instability high (MSI-H) metastatic colorectal cancer. Mogelijk met een PD-L1 expressie marker. Fabrikant verwacht registratie in het eerste kwartaal van 2021.

Therapeutic value

Frequency of administration

1 times every 3 weeks

Dosage per administration

200 mg

SmPC; NCT02563002
Additional comments
Toediening op dag 1 van iedere cyclus van 21 dagen. Maximaal 2 jaar behandeling. 
Nota Bene: voor monotherapie ook 1 x 400mg per 6 weken mogelijk.

Expected patient volume per year

Patient volume

312 - 624

Market share is generally not included unless otherwise stated.

NKR; Poynter et al. Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3208-15.
Additional comments
NKR 2016: 3.120 colon en rectum carcinomen, stadium 4. Microsatellite instability (MSI) occurs in 10−20% of colorectal cancers.

Expected cost per patient per year


< 90,000.00

Additional comments
Voor alle indicatie van pembrolizumab geldt een financieel arrangement dat is voortgekomen uit de onderhandelingen in de sluis. AIP per november 2017: €2.624,38 per injectieflacon 25MG/ML FL 4ML (oplossing). Uitgaande van een behandeling van 1 x per 3 weken 200 mg voor 12 maanden zou dat gaan om maximaal €90.000 per patiënt per jaar.

Potential total cost per year

Total cost


This amount gives an indication of the total cost. It is the result of the average expected patient volume times the average cost per patient. both per year.

Off label use

There is currently nothing known about off label use.

Indication extension

Indication extension


Indication extensions

Indicatieuitbreidingen worden weergegeven in de Horizonscan (Maagkanker, Hoofd- en halskanker, huidkanker, Longkanker, Nierkanker, et cetera).

References; SPS.

Other information

There is currently no futher information available.